Therapeutic Abortion (TA) is the medically-necessary termination of pregnancy due to maternal or fetal health complications. As a “wicked problem”, TA involves multiple stakeholders with competing biomedical and political ideologies. This research paper synthesizes evidence-based biomedical and health policy literature relating to TA, thereby advancing the aims of reproductive justice by supporting women in making informed health decisions. Firstly, a biomedical literature investigation was conducted to identify international evidence-based abortion standards, according to pregnancy trimester. Secondly, a policy analysis utilizing the “3-I” framework was conducted to determine the ideas, interests, and institutions involved in accessing safe and equitable TA in Canada.
The biomedical literature investigation indicates the combination of mifepristone and misoprostol is the “gold standard” for the medical termination of pregnancy in first trimester; dilation and evacuation is the preferred method for second trimester surgical abortion; and mifepristone followed by misoprostol can induce third trimester labour and delivery of a stillborn. Moreover, polarized discourses regarding fetal personhood (ideas), anti-abortion lobbying efforts (interests), and the policy legacy of Canadian federalism (institutions) negatively affect access to safe and equitable abortions in Canada, by deterring the use of evidence-based abortion guidelines. As a result of the political context surrounding TA in Canada, the availability of internationally recognized, evidence-based abortion practices does not guarantee safe and equitable TA access. Consequently, inter-sectoral collaboration between biomedical and health policy professionals is recommended in order to establish and implement broadly accessible TA services in Canada.